Endoscopy of the Upper Gastrointestinal Tract (Upper GI Endoscopy) is performed to evaluate the oesophagus (food pipe), stomach, and duodenum (upper small intestine) for abnormalities. This is done by using a flexible fibreoptic instrument that allows Dr Trehan to directly visualise these organs from the inside. Symptoms which may prompt an endoscopy include difficulty swallowing (dysphagia) or painful swallowing (odynophagia). These symptoms may indicate a narrowing in the oesophagus (known as a stricture), ulceration or inflammation of the oesophagus (oesophagitis).
More commonly, the test is done to search for a cause of blood loss leading to iron-deficiency anaemia (low haemoglobin or blood count). Inflammation of the lining of the stomach (known as gastritis, gastric erosions, erosive gastritis) or duodenum (duodenal erosions or duodenitis) may progress to ulceration – a stomach ulcer or duodenal ulcer. Any of these conditions can cause a slow, unnoticed but steady blood loss, or rarely a severe, dramatic loss of blood that can be life-threatening.
Prior to having an Upper GI Endoscopy, you would need to be fasted overnight so that the stomach is empty. Mild sedation is given, usually via an intravenous cannula. This will relieve anxiety, make the procedure easier to tolerate, and usually cause amnesia for the event.
During the procedure, Dr Trehan will use a thin, flexible fibreoptic instrument to visualise the inside of the oesophagus, stomach and duodenum. Photographs or even video images may sometimes be taken for future reference, for example to compare with pictures taken after appropriate treatment. If a small biopsy is needed for diagnosing inflammatory bowel disease involving the small bowel, for example, coeliac disease, biopsies from the small bowel beyond the stomach can be taken. Any areas of abnormality may be biopsied during the procedure – this is painless. Tissue obtained from a biopsy is sent to a pathology laboratory for analysis.
After the procedure, specialised nursing staff will care for you during your recovery. Once the effects of anaesthetic have worn off, you will be allowed home – normally on the same day as the procedure.